Application for Employment

DATE AVAILABLE TO BEGIN WORK PERSONAL INFORMATION LAST NAME (Print)

Instructions: Please furnish complete and accurate information. Applications will be verified. Incomplete applications will not be considered. In addition to completing this form, you many attach a resume detailing your professional, educational, and social actives.

FIRST NAME

INITIAL

OTHER NAME(S) UNDER WHICH ATTENDED SCHOOL OR EMPLOYED

SOCIAL SECURITY NUMBER

PRESENT ADDRESS

NUMBER AND STREET

CITY

STATE

ZIP CODE

TELEPHONE NUMBER

U.S. CITIZEN If no, enter Visa type ___No___Yes_______________ _ Visa No. _____________

PREMANENT ADDRESS IF DIFFERENT

NUMBER AND STREET

CITY

STATE

ZIP CODE

ARE YOU LESS THEN 18 YEARS OF AGE?

_______ NO HAVE YOU EVER BEEN CONVICTED OF A FELONY OR MISDEMEANOR EXCEPT FOR MINOR TRAFFIC OFFENSES? _____ NO _____YES (INDICATE) DATE OFFENSE DISPOSITION

_______ YES CITY STATE

EDUCATIONAL, SPECIAL INTERESTS, QUALIFICATIONS

EDUCATION TOTAL CREDIT YEARS SCHOOL NAME CITY STATE CERTIFICATE DIPLOMA DEGREE DID YOU GRAD. GRADE AVERAGE

COURSE OF STUDY

Grade High School (Show last attended) Business/Trade School College(s) Post-Graduate Education 1. 2. 3. 4. SPECIAL INTEREST

LIST OTHER TRAINING, QUALIFICATIONS AND SKILLS SUCH AS DRAFTER, APPRENTICESHIP, LANGUAGES, TYPING, ETC.

POSITION DESIRED

YOU MAY APPLY FOR UP TO 3 POSITIONS

CAN YOU WORK ANY SHIFT? EXPECTED RATE/ SALARY

WOULD YOU RELOCATE?

____ NO ____ YES

PROFESSIONAL REFERENCES (Please list 3)

PER

____ NO ____ YES

NAME: ________________________________________________________ NAME: ________________________________________________________ NAME: ________________________________________________________

RELATIONSHIP: ________________________________________ PHONE NUMBER: _______________________ RELATIONSHIP: ________________________________________ PHONE NUMBER: _______________________ RELATIONSHIP: ________________________________________ PHONE NUMBER: _______________________

An Equal Opportunity Employer

Page 1 of 2

EMPLOYMENT INFORMATION FROM MO./YR. TO MO./YR. FIRM NAME

Additional Instructions: List employment starting with your most recent employer. Account for all periods, including military service, and periods of unemployment. If the space provided does not cover at least 7 years, attach additional sheet or complete resume.

BASE EARNINGS $ PER

REASON FOR LEAVING

SUPERVISOR NAME/TELEPHONE NO. ( )

JOB TITLE AND DUTIES

FROM MO./YR.

TO MO./YR.

FIRM NAME

BASE EARNINGS $ PER

REASON FOR LEAVING

SUPERVISOR NAME/TELEPHONE NO. ( )

JOB TITLE AND DUTIES

FROM MO./YR.

TO MO./YR.

FIRM NAME

BASE EARNINGS $ PER

REASON FOR LEAVING

SUPERVISOR NAME/TELEPHONE NO. ( )

JOB TITLE AND DUTIES

OTHER WORK EXPERIENCE WITHIN PAST SEVEN (7) YEARS

NAME AND ADDRESS OF EMPLOYER 1 2

FROM / TO

OTHER WORK EXPERIENCE WITHIN PAST SEVEN (7) YEARS (CONTINUED)

NAME AND ADDRESS OF EMPLOYER 1 2

FROM / TO

READ CAREFULLY BEFORE SIGNING: 1. I have read and do understand the statements contained in this application and certify that they are true. 2. I understand that false or incomplete statements on this application or in any resume or supporting documents I have supplied are ground for dismissal if I am hired. 3. In connections with my application for employment, I authorize V2Soft, Inc. agents or employees (a) to procure information from any consumer reporting agency bearing on my credit worthiness, credit standing, credit capacity and (b) to contact all previous employers, personal references and educational Institutions. I understand that pre-employment investigation may also include a check of my criminal record, in any, and of the circumstances surrounding any conviction. I understand that any information gathered as a result of this investigation will be used solely for purposes of determining my fitness of employment. I consent to the investigation to be conducted and to the release to V2Soft, Inc. of the information specifically described in any separate consents and authorizations I have signed, which shall become a part of this application. In consideration of review of my application, I agree to release and hold harmless, agents, and employees and all previous employers and educational institutions, form any claimed liability arising from this investigation 5. In the event that I am employed by V2Soft, Inc. I agree to comply with and be governed by all its policies and procedures in effect at a given time, and I acknowledge that none of its policies constitutes terms of employment to paragraph 6 pre employment 7. I agree that this pre-employment statement supersedes any prior or future inconsistent understandings or agreements. I further agree that this arrangement may only be altered in writing directed to me personally and signed by authorized official of V2Soft. 8. In consideration of review of my application, I agree that any claim or lawsuit arising out of my employment with, or my application for employment with V2Soft, Inc. must be filed no more than six (6) months after the date of the employment action that is the subject of the claim or lawsuit. While I understand that the statute of limitation for claims arising out of an employment action may be longer than six (6) months, I agree to be bound by the six (6) months period of limitations and I WAIVE ANY STATUTE OF LIMITATIONS TO THE CONTRARY. Should a court determine in some future lawsuit that this provision allows an unreasonably short period of time to commence lawsuit, the court shall enforce this provision as far as possible and shall declare the lawsuit barred unless it was brought within the minimum reasonable time within which the suit should have been commenced. 6. I agree that my employment with V2Soft, if any, will be at-will and that either party may terminate the employment relations, with or without cause, at any time.

NOTE A PHOTOCOPY OF THIS STATEMENT SHALL BE AS VALID AS THE ORIGINAL

Applicants Signature ___________________________________________________ Date _________________ FOR PERSONAL USE ONLY General Comments, Test Information, Etc. Acceptable for Hire ___No ___Yes No Interest ___ (state) Reason
(This application will be considered active for twelve (12) months for the date filed. If you are hired, it becomes part of your official employment record)

Interviewers Signature

Date